Conjunctiva and cornea: Terrien against Mooren: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Conjunctiva and cornea: Terrien against Mooren

Sample item

A 55-year-old man has painless, slowly progressive thinning of the superior peripheral cornea with a yellow lipid line at the leading edge, a clear zone next to the limbus and no inflammation. The thinning is gutter-like with an intact epithelium. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Terrien marginal degeneration

Terrien marginal degeneration is a non-inflammatory, painless, slowly progressive peripheral thinning, usually superior, with lipid deposition and an intact epithelium. Mooren ulcer is painful, with an overhanging edge and inflammation. Treatment of Terrien is optical or surgical for astigmatism and perforation risk.

Option by option

  • A. Marginal catarrhal ulcer

    Catarrhal ulcer lies near the limbus with a clear zone but is a red, irritated eye with an epithelial defect.

  • B. Peripheral ulcerative keratitis of rheumatoid arthritis

    Peripheral ulcerative keratitis occurs with active systemic vasculitis and is painful and inflamed.

  • C. Terrien marginal degeneration (correct)

    Correct. A painless, quiet, gutter-like peripheral thinning with a lipid edge is Terrien.

  • D. Mooren ulcer

    Mooren ulcer is intensely painful, inflamed and has an overhanging undermined edge.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is C, Terrien marginal degeneration. Terrien marginal degeneration is a non-inflammatory, painless, slowly progressive peripheral thinning, usually superior, with lipid deposition and an intact epithelium.

Why is "Marginal catarrhal ulcer" not the answer?

Catarrhal ulcer lies near the limbus with a clear zone but is a red, irritated eye with an epithelial defect.

Why is "Peripheral ulcerative keratitis of rheumatoid arthritis" not the answer?

Peripheral ulcerative keratitis occurs with active systemic vasculitis and is painful and inflamed.

Why is "Mooren ulcer" not the answer?

Mooren ulcer is intensely painful, inflamed and has an overhanging undermined edge.

What concept does this question test?

It tests Conjunctiva and cornea: Terrien against Mooren in Ophthalmology. Mooren ulcer is painful, with an overhanging edge and inflammation. Treatment of Terrien is optical or surgical for astigmatism and perforation risk.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Conjunctiva and cornea: Terrien against Mooren?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.